Conroy Amy A
a Center for AIDS Prevention Studies , University of California , San Francisco.
J Sex Res. 2015;52(3):347-59. doi: 10.1080/00224499.2014.883590. Epub 2014 Mar 26.
Using the theory of gender and power (TGP) and data from the Tsogolo la Thanzi (TLT) study, we examined how relationship power shapes young people's decisions to test for HIV in rural Malawi (N=932), a high-HIV prevalence setting undergoing rapid expansions in testing services. We used generalized estimating equations (GEE) to examine associations among five constructs of relationship power (socioeconomic inequalities, relationship dominance, relationship violence, relationship unity, and mistrust), perceived risk, and receiving an HIV test over a 16-month period. The results indicate that young Malawians are testing for HIV at relatively high rates, repeatedly, and not just during pregnancy. Over the study period, 47.3% of respondents received at least one HIV test outside of TLT (range: 0-4). The GEE analysis revealed that men and women with higher levels of relationship unity were less likely to test for HIV. For men, being a victim of sexual coercion was an additional barrier to testing. Women's testing decisions were more strongly influenced by perceptions of a partner's risk for HIV than their own, whereas men relied more on self-assessments. The results highlight that testing decisions are deeply embedded within the relationship context, which should be considered in future HIV testing interventions.
运用性别与权力理论（TGP）以及来自索戈洛·拉·坦齐（TLT）研究的数据，我们考察了关系权力如何影响马拉维农村地区（N = 932）年轻人进行艾滋病毒检测的决定。马拉维农村地区艾滋病毒感染率很高，检测服务正在迅速扩展。我们使用广义估计方程（GEE）来研究在16个月期间，关系权力的五个构成要素（社会经济不平等、关系主导、关系暴力、关系团结和不信任）、感知风险与接受艾滋病毒检测之间的关联。结果表明，马拉维年轻人进行艾滋病毒检测的比率相对较高，而且是反复检测，并非仅在孕期检测。在研究期间，47.3%的受访者在TLT之外至少接受过一次艾滋病毒检测（范围：0 - 4次）。GEE分析显示，关系团结程度较高的男性和女性进行艾滋病毒检测的可能性较小。对男性而言，遭受性胁迫是检测的又一障碍。女性的检测决定受对伴侣艾滋病毒感染风险认知的影响比受自身风险认知的影响更大，而男性更多地依赖自我评估。结果突出表明，检测决定深深植根于关系背景之中，未来的艾滋病毒检测干预措施应考虑这一点。
